FREEHOLD TOWNSHIP RENTAL PROPERTY APPLICATION & INITIAL LANDLORD REGISTRATION

Transcription

1 FREEHOLD TOWNSHIP RENTAL PROPERTY APPLICATION & INITIAL LANDLORD REGISTRATION {Please type or print legibly} Registration# LR-. SECTION - 1 Application Fee:. RENTAL PROPERTY INFORMATION: Building# (If applicable), Unit#, Total # of Units per Bldg: (If applicable). Total # of Bedrooms:, Heating Source: (Please circle one) Natural Gas Electric Propane Fuel Oil If fuel oil is used, please provide below the name and address of the fuel oil Dealer servicing the unit and the grade of fuel oil used. Fuel Oil Dealer:. Phone #. Grade of Oil:. SECTION - 2 OWNER INFORMATION: (Provide Copy of Photo I.D.) Please list below the name and address of all record owners of the rental property, building or the rental business. This must include: all general partners in the case of a partnership, all members in the case of a Limited Liability Company, and all shareholders in the case of a Corporation. Owner's Name: (Last, First). Mailing Address: (P.O. Box not acceptable). County:. (Note: If the owner does not reside in Monmouth County then an in county representative s contact information must be provided below.)

2 If Record Owner is not a Corporation: (Place check mark). If Record Owner is a Corporation, please list the names and addresses of the Registered Agent and of the Corporate officers as follows: Corporation/Partnership Name(s):. List additional Owners and addresses: (If applicable). *List below the Name and Address of all holders (bank, equity loan, mortgage, etc) recorded on this property:. No Mortgage on Property: (Place check mark). MONMOUTH COUNTY REPRESENTATIVE: (Provide Copy of Photo I.D. To Verify Address) If Owner of Record is NOT located in Monmouth County, then please provide below: the name, address, and telephone number(s) of a person who resides in Monmouth County and is authorized to accept notices from a tenant or municipality, to issue receipts for these notices and to accept service of process on behalf of the record owner, and who can also serve as an individual representative of the record owner or managing agent who may be reached or contacted at any time in the event of an emergency with authority to make emergency decisions concerning the building or unit, including the making of repairs. Authorized Agent Name:. Address:. * Emergency Contact: (Mandatory Requirement) Name:. Address:. (Please provide no less than two telephone numbers where your emergency contact may be reached during both day and evening hours & at least one

3 SECTION - 3 MANAGING AGENT INFORMATION: (If Applicable) Managing Agent/Company Name:. Address:. There is no Managing Agent: (Place check mark). If applicable: Please provide the name, address and phone number of the Superintendent, Janitor, Custodian or other person employed to provide regular maintenance services. Name of Super/Custodian/Janitor, etc.. Address:... Landlord or Authorized Representative (Print & Sign) Date

4 FREEHOLD TOWNSHIP TENANT INFORMATION SECTION 4 TENANT INFORMATION: Registration # LR-. FOR EACH RENTAL UNIT---you MUST provide the NAME, AGE and GENDER of EACH AND EVERY TENANT IN THE RENTAL UNIT (not just on the lease), including children. Apart#/Unit# Building# (if applicable) #of Bdrms # of Tenants LAST NAME FIRST NAME AGE GENDER

5 FREEHOLD TOWNSHIP FLOOR PLAN DETAIL SECTION - 5 Registration # LR-. FLOOR PLAN SECTION: FOR EACH UNIT: Please provide below, a detailed layout /floor plan for this unit, with accurate room dimensions. No space shall be used for sleeping purposes unless so designated as a sleeping area. Attach additional sheets, if needed.